Individual
DR. THEODORE B. BERNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1155 MILL ST, RENO, NV 89502-1576
(775) 982-7878
(775) 982-4196
Mailing address
850 HARVARD WAY, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
3191
NV
207RC0000X
Cardiovascular Disease Physician
G22670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016077
—
NV
01
—
11050642
CAQH
—
01
—
CC2328
BLUE CROSS BLUE SHIELD
NV
05
—
XPY183369
—
CA
Enumeration date
07/16/2006
Last updated
07/25/2017
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